While there is growing demand for assisted reproductive technology, many are hesitant to seek out help when they have trouble with conceiving for fear of just how much infertility treatments cost. For this reason, a group of researchers at the University of California-Francisco decided to assess just how expensive these treatments really are.
For the study, the researchers recruited patients from eight different reproductive endocrinology clinics. These patients were then followed for a period of 18 months, beginning with the initiation of treatment. Throughout the process, they were asked to keep cost diaries in which they recorded all of their out-of-pocket expenses, including office visits, medications, meals, travel, parking fees and any other expenses that were related to obtaining treatment. Altogether, 332 couples keep diaries.
Out of the 332 couples who participated in the study, the breakdown of treatment methods was as follows: 55 percent used IVF, 19 percent used non-cycle based therapy (treatments such as fibroid surgery or hysteroscopic manipulation), four percent used ovulation-inducing drugs only and 22 percent used intrauterine insemination (IUI).
What the research team found was that there is a wide variation in what people pay in out-of-pocket costs for infertility treatments, depending upon what level of treatment that the individual might require. At the lower end of the scale were the people who were able to use medication only to achieve their dreams of parenthood, who paid an average of only $912. At the other end of the spectrum, however, were those requiring IVF, who had significantly higher treatments costs, paying an average of $19,234.
The overall average costs paid by the patients themselves was about $5,338. Each additional cycle of IVF cost about $6,955. When male factor infertility was involved, couples paid an additional $9,404 compared to when female factor infertility was the source of conception difficulties. When couples had insurance coverage, this did reduce costs by about $2,152. Total expense, however, did not correlate with how successful the couples were in achieving pregnancy.
According to Dr. James F. Smith, Assistant Professor in Residence and Director of Male Reproductive Health at the University of California-San Francisco, urologists are often one of the first doctors consulted when people are having problems with conceiving a child, and wanting to know just how much fertility treatments cost is at the forefront of their minds. The high costs of infertility treatments are a significant burden on many patients and may play a large role in their decision-making process. By providing patients with a “real world” estimate of these costs, he and his colleagues hope to help patients make more informed treatment choices.
According to the press release from the study, as many as almost one-quarter of all couples will experience problems with infertility. In fact, somewhere between eight to 18 percent of men and 12 percent of women will obtain infertility treatment at some point in their lives. Unfortunately for many, the costs are quite burdensome, with many couples having either no or only partial insurance coverage. In addition, socioeconomic status may have an influence of how successful treatment is if patients cannot afford the particular treatment best suited to their own needs. The authors note that many of the couples who underwent IVF had annual income exceeding $100,000.
While data indicate that the usage of infertility treatments is growing every year in the United States, it actually has one of the lowest usage rates of IVF when compared to other developed countries. The U.S. also has higher out-of-pocket costs for this procedure. Compared to Australia, which has the highest rate of IVF in the world, IVF in the U.S. costs about 44 percent of annual disposable income while Australia has costs of only 6 percent of annual disposable income.
The study, which seeks to help clarify out-of-pocket costs for infertility treatments in the U.S., was published on December 6, 2013 in The Journal of Urology.
By Nancy Schimelpfening
Email Interview With Dr. James F. Smith